HELSEVEL-Gode og effektive helse-, omsorgs- og velferdstjenester

The number of newly arrived migrant women to Oslo who are pregnant and give birth at hospitals in the Oslo region have increased the past years. Compared to the general population studies have shown that migrant women are more at risk when it comes to complications during their pregnancies and for their newborns. By focusing on the pregnant women's own experiences with maternal health care provision in Oslo and by mapping current maternity service challenges the MIPREG project will seek to identify factors that contribute to disparities in pregnancy outcomes. The study will be carried out in several phases. In the first phase we conducted linked registry studies to determine variation in maternal and perinatal outcomes with regards to country of birth. We have now published three articles and are presently writing another two articles. In the second phase we conducted exit-interviews with 400 recently arrived migrant women after birth to assess their experiences with Norwegian maternity care. In addition we performed in-depth interviews with migrant women and health personnel at health clinics and three birth clinics in the Oslo region. The aim is to understand how current pregnancy care is adapted to the heterogeneous group of migrant women. The two first phases forms the knowledge basis for the third phase: the development of a pilot maternity package interventions that targets 150 newly arrived migrant women. This include measures such a third-trimester check-up at the hospital where the women will give birth and the access to a mobile information "app" with audiovisual information about danger signs in pregnancy in the woman's own language. The pilot intervention started up in the Spring of 2021 and we have now recruited 145 women and recruitment will close on Dec 1st 2022. The evaluation interviews will continue throughout Spring of 2023. The Project has been presented at international and national research conferences and seminars. The datacollection for Phase 1 and 2 ended in March 2020. The last phase, the Pilot Intervention Phase has been developed and startet in the spring of 2021 and will continue until Spring 2023. The ultimate aim of the study is to improve pregnancy and birth care among pregnant migrant women in Oslo. The project is a partnership between the Norwegian Research Centre for Women's Health, University of Oslo, Division of obstetrics at OUS, AHUS and the Healthcare Department in Oslo kommune.

Background: The health care needs of migrant women is a growing concern. Previous studies have shown a higher risk of pregnancy complications among migrant subgroups compared to non-migrant women. Factors responsible for this gap in maternal health might be related to inadequate communication and misinterpretations of expectations and norms; however, studies exploring migrants own perspectives is missing. This MIPREG proposal aims to fill this knowledge gap by incorporating migrant womens view on their own care, and based on this insight pilot an appropriate intervention package to assure Migrant Friendly Care. Aims: The primary aim of the present study was therefore to identify the health-care related factors that contribute to inequity in maternity outcomes among recent migrant women, and address these factors to ultimately improve health outcomes. Secondary aims are: - to determine disparities in pregnancy outcomes according to migration status - to map current maternity service challenges - to measure user satisfaction, and perceived quality of care - to design and pilot a Migrant Friendly Maternity Care Package Material and methods: We use a health systems design with a mixed methods approach. in two stages . Stage 1 aims through both quantitative (linked registry studies and postnatal validated questionnaires) and qualitative (in-depth interviews with migrant women and health staff) approaches to establish new knowledge of where the gaps are in migrant maternal care. Stage 2 aims to, based on result from stage 1, develop and pilot an intervention based on elements from successful interventions elsewhere. Four work packages with specific actions is defined. Anticipated use of the results: Generated knowledge will improve services for migrant women, engender empowerment by users and improve existing training programs for health staff interacting with migrant populations. The results can be used in efforts to scale up Migrant Friendly care to women elsewhere.